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Estimating Mental Health Expenditures Using National Household Survey Data

使用全国家庭调查数据估算心理健康支出

基本信息

批准号：
8334497
负责人：
ERIC SLADE
金额：
$ 19.58万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-20 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8334497
关键词：
Accident and Emergency department Address Admission activity Adolescent Adult Age Ambulatory Care Facilities Calendar Caring Categories Censuses Charities Child Chronic Classification Clinical Community Hospitals Computer software Data Data Sources Databases Development Diagnosis Disadvantaged Elderly Enrollment Evaluation Expenditure Frequencies Future HIV HIV diagnosis Health Health Care Costs Health Care Reform Health Expenditures Health Insurance Health Policy Health Services Healthcare Hepatitis Hepatitis C Home environment Hospitals Household Incentives Inpatients Insurance Coverage Low income Medicaid Medical Medicare/Medicaid Mental Health Mental disorders Methodology Methods Patients Persons Pharmaceutical Preparations Policy Analysis Population Procedures Qualifying Records Regression Analysis Research Resources Sampling Scheme Services Subgroup Substance Use Disorder Surveys Visit age group base design health care service utilization innovation insight interest medical specialties meetings mental disorder diagnosis parity service utilization substance abuse treatment young adult

项目摘要

DESCRIPTION (provided by applicant): The Medical Expenditure Panel Survey (MEPS) is a vital national resource for assessing the impacts of the 2010 Patient Protection and Affordable Care Act on mental health care expenditures. However, the MEPS is known to under-represent mental health expenditures, in general, and evidence suggests the magnitude of bias could be larger for persons with high expenditures for mental health care. This study addresses long- standing questions surrounding the accuracy of MEPS expenditure estimates for persons with mental illness. It also will provide information about biases in MEPS expenditure data for other hard-to-reach populations, such as low-income persons with HIV and persons with substance use disorders. The study's specific aims are: 1) to quantify, for subgroups defined by health condition category, insurance coverage, and age, the bias in MEPS estimates of annual expenditures for emergency department visits and inpatient care; and 2) to demonstrate an estimation method that will achieve a more representative health care expenditure distribution for subgroups of emergency department patients and inpatients that are underrepresented in MEPS. The State Inpatient Databases (SID) and State Emergency Department Databases (SEDD) contain a complete census of all inpatient stays and emergency department visits at community hospitals. Data from the SID and SEDD and data from the MEPS will be used to construct annual cross-sectional samples of persons who had at least one qualifying emergency department visit or inpatient admission during a calendar year. MEPS estimates of expenditures for emergency department and inpatient hospital services use and expenditures in the MEPS will then be compared to these same quantities developed from the SID/SEDD. We will examine expenditure differences especially in relation to mental disorder diagnoses, substance use disorder diagnoses, HIV, Hepatitis C, insurance coverage, and age group, using moment condition constraints developed from SID/SEDD. The study's results will provide insight into the importance of MEPS expenditure biases for subpopulations that may be hard-to-reach in a household survey, and will provide preliminary evidence for a future study of how the PPACA impacts health expenditures for persons with mental illness.

描述（由申请人提供）：医疗支出小组调查 (MEPS) 是评估 2010 年患者保护和平价医疗法案对精神卫生保健支出影响的重要国家资源。然而，众所周知，总体而言，MEPS 未能充分代表精神卫生支出，并且有证据表明，对于精神卫生保健支出较高的人来说，偏差的程度可能更大。本研究解决了围绕精神疾病患者 MEPS 支出估算准确性的长期存在的问题。它还将提供有关其他难以接触人群（例如低收入艾滋病毒感染者和药物滥用障碍患者）的 MEPS 支出数据偏差的信息。该研究的具体目标是： 1) 对于按健康状况类别、保险覆盖范围和年龄定义的亚组，量化急诊科就诊和住院护理年度支出的 MEPS 估计值的偏差； 2) 论证一种估计方法，该方法将为 MEPS 中代表性不足的急诊科患者和住院患者亚组实现更具代表性的医疗保健支出分配。州住院数据库 (SID) 和州急诊科数据库 (SEDD) 包含社区医院所有住院患者和急诊科就诊的完整普查。来自 SID 和 SEDD 的数据以及来自 MEPS 的数据将用于构建在一个日历年内至少接受过一次合格急诊科就诊或住院治疗的人员的年度横截面样本。然后，MEPS 对急诊科和住院医院服务使用支出的估计以及 MEPS 中的支出将与 SID/SEDD 制定的相同数量进行比较。我们将使用从 SID/SEDD 开发的时刻条件约束来检查支出差异，特别是与精神障碍诊断、物质使用障碍诊断、艾滋病毒、丙型肝炎、保险范围和年龄组相关的支出差异。该研究的结果将深入了解 MEPS 支出偏差对于家庭调查中可能难以触及的亚人群的重要性，并将为未来研究 PPACA 如何影响精神疾病患者的医疗支出提供初步证据。